HHS Secretary Kennedy pledges action on AI-driven Medicare prior authorization program WISeR
Updated
Updated · MarketWatch · Apr 27
HHS Secretary Kennedy pledges action on AI-driven Medicare prior authorization program WISeR
10 articles · Updated · MarketWatch · Apr 27
About 6.4 million Medicare enrollees in six states face delays of up to eight weeks for procedures under the WISeR pilot, with Washington state patients and providers reporting severe impacts.
Senator Cantwell urged faster claim responses and human review of denials, citing increased pain, opioid use, and administrative burdens. Providers report most determinations are denials, often without clear justification.
WISeR aims to reduce waste and costs but is criticized for incentivizing denials and raising healthcare costs. CMS is monitoring performance, while calls grow for transparency and corrective action before program expansion.
Are AI-driven cost savings just shifting burdens to patients and doctors?
When an AI denies your medical claim, who is held accountable?
How can we ensure human oversight effectively governs healthcare AI decisions?
Is the government's fraud-fighting AI causing more harm than good?
Why are AI approval times weeks long when they were promised in days?